The Indian scene Chopra, R
Journal of clinical oncology,
09/2001, Letnik:
19, Številka:
18 Suppl
Journal Article
Recenzirano
Breast cancer is the second most common cancer among women in India, after cancer of the cervix uteri. Presently, 75,000 new cases occur in Indian women every year. This figure must be viewed against ...the backdrop that the national cancer registry and the hospital-based tumor registries hardly sample 3% of the total population. Locally advanced breast cancer constitutes more than 50% to 70% of patients presenting for treatment. The management of the patients varies according to the hospital the patient seeks treatment from. In this vast country, hospitals vary from peripheral hospitals with basic facilities to the specialized institutions in the metropolitan centers with all specialists, medical oncologists, radiation oncologists, surgical oncologists, and supporting facilities. In the peripheral hospitals, the treatment is invariably a radical mastectomy with or without radiotherapy. In the metropolitan areas and in specialized cancer institutions, management mirrors international recommendations with brachiocephalic trunk or modified radical mastectomy, radiation therapy, and chemotherapy.
To guide clinicians and policymakers in three global resource-constrained settings on treating patients with metastatic breast cancer (MBC) when Maximal setting-guideline recommended treatment is ...unavailable.
A multidisciplinary, multinational panel reviewed existing ASCO guidelines and conducted modified ADAPTE and formal consensus processes.
Four published resource-agnostic guidelines were adapted for resource-constrained settings; informing two rounds of formal consensus; recommendations received ≥75% agreement.
Clinicians should recommend treatment according to menopausal status, pathological and biomarker features when quality results are available. In first-line, for hormone receptor (HR)-positive MBC, when a non-steroidal aromatase inhibitor and CDK 4/6 inhibitor combination is unavailable, use hormonal therapy alone. For life-threatening disease, use single-agent chemotherapy or surgery for local control. For premenopausal patients, use ovarian suppression or ablation plus hormone therapy in Basic settings. For human epidermal growth factor receptor 2 (HER2)-positive MBC, if trastuzumab, pertuzumab, and chemotherapy are unavailable, use trastuzumab and chemotherapy; if unavailable, use chemotherapy. For HER2-positive, HR-positive MBC, use standard first-line therapy, or endocrine therapy if contraindications. For triple-negative MBC with unknown PD-L1 status, or if PD-L1-positive and immunotherapy unavailable, use single-agent chemotherapy. For germline
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mutation-positive MBC, if poly(ADP-ribose) polymerase inhibitor is unavailable, use hormonal therapy (HR-positive MBC) and chemotherapy (HR-negative MBC). In second-line, for HR-positive MBC, Enhanced setting recommendations depend on prior treatment; for Limited, use tamoxifen or chemotherapy. For HER2-positive MBC, if trastuzumab deruxtecan is unavailable, use trastuzumab emtansine; if unavailable, capecitabine and lapatinib; if unavailable, trastuzumab and/or chemotherapy (hormonal therapy alone for HR-positive MBC).Additional information is available at www.asco.org/resource-stratified-guidelines. It is ASCO's view that healthcare providers and system decision-makers should be guided by the recommendations for the highest stratum of resources available. The guideline is intended to complement but not replace local guidelines.
Triazole tethered 7-chloroquinoline-pyrimidine-5-carboxylate hybrids were synthesized and evaluated for antiplasmodial activity against chloroquine sensitive (CQS) NF54 strain of Plasmodium ...falciparum. The most active hybrids of the series were further screened against the chloroquine resistant (CQR) Dd2 strain of the parasite and for in vitro cytotoxicity against mammalian Vero cell lines. Further, their physico-chemical properties, binding studies with hemin (monomeric &μ-oxo dimeric) and DNA pUC-18, calf thymus (CT) led us to plausible proposed binding mode of the most active member of the present series.
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•New antimalarial compounds.•Efficacious synthesis.•Binding with DNA.•Binding with Heme and μ-oxoheme.
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•A pyrene based sensor with aggregation enhanced excimer emission synthesized.•This forms highly emissive crystalline nanoaggregates in THF:HB 90% v/v mixture.•The emissive aggregates ...detect picric acid upto zeptogram level in direct contact mode.
A pyrene-based small molecular weight probe, exhibiting aggregation enhanced excimer emission has been synthesized. The crystalline emissive form detects 2,4,6-trinitrophenol (picric acid) at parts-per-billion concentration in solution and as low as 0.46 attogram in direct contact mode, operating predominantly in a static quenching mechanism, proposed on the basis of steady state and life-time fluorescence measurements.
Biologics play a key role in cancer treatment and are principal components of many therapeutic regimens. However, they require complex manufacturing processes, resulting in high cost and occasional ...shortages in supply. The cost of biologics limits accessibility of cancer treatment for many patients. Effective and affordable cancer therapies are needed globally, more so in developing countries, where health care resources can be limited. Biosimilars, which have biologic activity comparable to their corresponding reference drugs and are often more cost effective, have the potential to enhance treatment accessibility for patients and provide alternatives for decision makers (ie, prescribers, regulators, payers, policymakers, and drug developers). Impending patent expirations of several oncology biologics have opened up a vista for the development of corresponding biosimilars. Several countries have implemented abbreviated pathways for approval of biosimilars; however, challenges to their effective use persist. Some of these include designing appropriate clinical trials for assessing biosimilarity, extrapolation of indications, immunogenicity, interchangeability with the reference drug, lack of awareness and possibly acceptance among health care providers, and potential political barriers. In this review, we discuss the potential role and impact of biosimilars in oncology and the challenges related to their adoption and use. We also review the safety and efficacy of some of the widely used biosimilars in oncology and other therapeutic areas (eg, bevacizumab, darbepoetin, filgrastim, rituximab, and trastuzumab).
The dilution controlled aggregation enhanced emission of spherically aggregated form of a triazole based probe dies down upon detecting iodide over other inorganic anions. The sensing is realised as ...a dynamic quenching mechanism dominated event. Being highly selective for iodide, the probe finds application in the detection of iodide in human urine.
The incorporation of alkyl as well as phenyl groups at C‐4, a key position of 2‐oxo‐1,2,3,4‐tetrahydropyrimidine‐5‐carboxylates, responsible for antagonist/agonist switching of the calcium channel ...blocking activity of these compounds, has been achieved by the addition of organozinc reagents to the corresponding 2‐oxo‐1,2‐dihydropyrimidine‐5‐carboxylate derivatives catalysed by BF3OEt2.
An efficacious diversification of the key C‐4 position of 2‐oxo‐1,2‐dihydropyrimidine‐5‐carboxylates has been achieved through the addition of organozinc reagents.
Abstract
The incorporation of alkyl as well as phenyl groups at C‐4, a key position of 2‐oxo‐1,2,3,4‐tetrahydropyrimidine‐5‐carboxylates, responsible for antagonist/agonist switching of the calcium ...channel blocking activity of these compounds, has been achieved by the addition of organozinc reagents to the corresponding 2‐oxo‐1,2‐dihydropyrimidine‐5‐carboxylate derivatives catalysed by BF
3
OEt
2
.
The promise of hybrid antimalarial agents and the precedence set by the antimalarial drug ferroquine prompted us to design ferrocene-pyrimidine conjugates. Herein, we report the synthesis, ...electrochemistry and anti-plasmodial evaluation of ferrocenyl-pyrimidine conjugates against chloroquine susceptible NF54 strain of the malaria parasite Plasmodium falciparum. Also their physicochemical properties have been studied.
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•New ferrocene-pyrimidine conjugates are evaluated for antiplasmodial activity.•All synthesized compounds depict single electron reversible oxidation behavior.•Physicochemical properties of the synthesized compounds have been evaluated.•SAR of the new hybrids has been established.
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